血管异常儿科患者的血液病和非血液病发病率:儿科健康信息系统数据库研究

Bryony Lucas, S. Malay, Irina B. Pateva
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摘要

血管畸形(VA)是一组异质性疾病,包括血管畸形和血管肿瘤。在儿科人群中,有关相关血液和非血液疾病的发生频率以及患者总体预后的数据非常稀少。 本研究的目的是确定接受手术的血管畸形患者并发某些血液病和非血液病的比率,并与未接受手术的患者进行比较。研究血管异常患者入住重症监护室的比率和出院死亡率。 这是一项多中心回顾性队列研究,使用的数据来自儿科健康信息系统。数据库查询了 2016 年 1 月至 2021 年 9 月期间住院的 0-18 岁诊断为血管异常的儿童。 最常见的血液病是血小板减少症、缺铁性贫血和静脉血栓。最常见的非血液病是电解质失衡。患有其他外周血管系统先天性畸形、脑海绵畸形和散发性动静脉畸形的患者入住重症监护室的比例最高。淋巴畸形和原发性淋巴水肿患者的出院死亡率最高。 这是迄今为止对患有VA的儿科患者及其并发症和预后进行的最大规模的数据库研究。虽然我们的研究无法证明两者之间存在关联,但我们希望我们的研究结果将为更广泛地研究这些已确定病症和结果的影响奠定基础,并有助于改善对VA患者的管理。
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Frequency of Hematologic and Nonhematologic Conditions in Pediatric Patients with Vascular Anomalies: A Pediatric Health Information System Database Study
Vascular anomalies (VA) are a heterogeneous group of diseases which include vascular malformations and vascular tumors. In the pediatric population, there is a sparsity of data on the frequency of associated hematologic and nonhematologic conditions as well as overall outcomes for patients. The objective of this study was to determine the rate of certain concurrent hematologic and nonhematologic conditions in patients with VA who underwent procedures and compare those to patients who did not undergo procedures. To examine the rates of intensive care unit admissions and discharge mortality in patients who had a vascular anomaly. This is a multicenter retrospective cohort study using data from the Pediatric Health Information System. The database was queried for children 0–18 years old with a diagnosis of a VA who had inpatient encounters between January 2016 and September 2021. The most common hematologic conditions were thrombocytopenia, iron deficiency anemia, and venous thrombosis. The most common nonhematologic condition was electrolyte imbalances. Intensive care unit admissions were highest among patients with other congenital malformations of the peripheral vascular system, cerebral cavernous malformations, and sporadic arteriovenous malformations. Discharge mortality was highest in patients with lymphatic malformations and primary lymphedema. This is the largest database study of pediatric patients with VA and their concurrent medical conditions and outcomes to date. While our study could not prove associations, we hope that our results will serve as a foundation for more extensive research regarding the impact of these identified conditions and outcomes and contribute to improved management of patients with VA.
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